Dua K S, Ren J, Bardan E, Xie P, Shaker R
MCW Dysphagia Institute, Department of Medicine, Medical College of Wisconsin, Milwaukee, USA.
Gastroenterology. 1997 Jan;112(1):73-83. doi: 10.1016/s0016-5085(97)70221-x.
BACKGROUND & AIMS: Deglutitive glottal function during the preparatory phase of swallowing and its coordination with bolus transit during normal eating are important for airway protection. The aim of this study was to examine this coordination during consumption of a normal meal.
Fifteen healthy volunteers were studied using a videoendoscopic and videofluoroscopic technique.
A total of 207 liquid and 470 solid bolus swallows were analyzed. In 60% of liquid and 76% of solid food swallows, the bolus was seen in the pharynx before a swallow was initiated. Entry of boluses into the pharynx was associated with brief partial adduction of the vocal cords. Solid food entered and traversed the pharynx at the midline, whereas liquid bolus was split around the larynx and rejoined in the hypopharynx. Swallowing was initiated significantly earlier when bolus made contact with the upper third of the epiglottis compared with vallecula or pyriform sinuses.
In more than half of the instances, during normal eating, food enters the pharynx during the preparatory phase before a swallow is initiated, the path of pharyngeal transit of solid bolus is different from that of liquid bolus, and the epiglottal edge appears to be the most sensitive trigger zone for swallowing.
吞咽准备阶段的吞咽声门功能及其在正常进食过程中与食团运输的协调对于气道保护很重要。本研究的目的是检查正常进餐时的这种协调性。
使用视频内镜和视频荧光透视技术对15名健康志愿者进行研究。
共分析了207次液体食团和470次固体食团吞咽。在60%的液体食团和76%的固体食物吞咽中，在开始吞咽之前食团出现在咽部。食团进入咽部与声带短暂部分内收有关。固体食物在中线进入并穿过咽部，而液体食团在喉部周围分开并在下咽部重新汇合。与会厌谷或梨状窦相比，当食团接触会厌上三分之一时，吞咽开始明显更早。
在超过一半的情况下，在正常进食期间，食物在开始吞咽之前的准备阶段进入咽部，固体食团的咽部运输路径与液体食团不同，会厌边缘似乎是吞咽最敏感的触发区域。
